§431:10H-221  Requirements for applicationforms and replacement coverage.  (a)  Application forms shall includequestions designed to elicit information as to whether, as of the date ofapplication, the applicant has another long-term care insurance policy orcertificate in force or whether a long-term care policy or certificate isintended to replace any other accident and health or sickness or long-term carepolicy or certificate presently in force.  A supplementary application or otherform to be signed by the applicant and producer, except where the coverage issold without a producer, containing the questions may be used.  With regard toa replacement policy issued to a group defined by paragraph (1) under thedefinition of "group long-term care insurance" in section431:10H-104, the following questions may be modified only to the extentnecessary to elicit information about accident and health or sickness andlong-term care insurance policies other than the group policy being replaced;provided that the certificate holder has been notified of the replacement:

(1)  Do you have another long-term care insurancepolicy or certificate in force (including a health care service contract orhealth maintenance organization contract)?

(2)  Did you have another long-term care insurancepolicy or certificate in force during the last twelve months?

(A)  If so, with which company?

(B)  If that policy lapsed, when did it lapse?

(3)  Are you covered by medicaid?

(4)  Do you intend to replace any of your medical oraccident and health or sickness insurance coverage with this policy(certificate)?

(b)  Producers shall list any other accidentand health or sickness insurance policies they have sold to the applicant, andthe producer shall list policies sold that are still in force and list policiessold in the past five years that are no longer in force.

(c)  Upon determining that a sale will involvereplacement, an insurer, other than an insurer using direct responsesolicitation methods, or its producer, shall furnish the applicant, prior toissuance or delivery of the individual long-term care insurance policy, anotice regarding replacement of accident and health or sickness or long-termcare coverage.  One copy of the notice shall be retained by the applicant and anadditional copy signed by the applicant shall be retained by the insurer.  Therequired notice shall be provided in the same manner as shown in section 14C ofthe April, 2002, NAIC Long-Term Care Insurance Model Regulation.

(d)  Insurers using direct responsesolicitation methods shall deliver a notice regarding replacement of accidentand health or sickness or long-term care coverage to the applicant uponissuance of the policy.  The required notice shall be provided in the samemanner as shown in section 14D of the April, 2002, NAIC Long-Term CareInsurance Model Regulation.

(e)  Where replacement is intended, thereplacing insurer shall notify, in writing, the existing insurer of theproposed replacement.  The existing policy shall be identified by the insurer,name of the insured, and policy number or address including zip code.  Noticeshall be made within five working days from the date the application isreceived by the insurer or the date the policy is issued, whichever is sooner.

(f)  Life insurance policies that acceleratebenefits for long-term care shall comply with this section if the policy beingreplaced is a long-term care insurance policy.  If the policy being replaced isa life insurance policy, the insurer shall comply with the replacementrequirements for life insurance policies.  If a life insurance policy thataccelerates benefits for long-term care is replaced by another policy, thereplacing insurer shall comply with both the long-term care and the lifeinsurance replacement requirements. [L 1999, c 93, pt of §2; am L 2001, c 216,§21; am L 2003, c 212, §97; am L 2007, c 233, §16]